CHANGES IN SERUM INSULIN AND PROINSULIN LEVELS IN GESTATIONAL DIABETES - A BRIEF REVIEW
CHANGES IN SERUM INSULIN AND PROINSULIN LEVELS IN GESTATIONAL DIABETES - A BRIEF REVIEW

Summary/Abstract: GESTATIONAL DIABETES MELLITUS (GDM) IS A COMPLICATION OF PREGNANCY CHARACTERIZED BY HYPERGLYCAEMIA WITH ONSET OR FIRST RECOGNITION IN PREGNANCY. PREVALENCE OF GDM IS INCREASING GLOBALLY. GDM IS ASSOCIATED WITH SHORT AND LONG-TERM MATERNOFETAL COMPLICATIONS AND IS CONSIDERED A PREDIABETES STATE BECAUSE IT HAS A HIGH RISK OF DEVELOPING TYPE 2 DIABETES FOR BOTH MOTHER AND CHILD. THE PATHOGENESIS OF GDM INCLUDES INSULIN RESISTANCE (IR) AND Β-CELL DYSFUNCTION. PATIENTS WITH GDM ARE MORE INSULIN RESISTANT THAN PREGNANT NONDIABETIC WOMEN7 AND THEY ARE PREDISPOSED TO HAVE DEFECTIVE INSULIN SECRETION AND DEFECTIVE INSULIN ACTION. IN GDM, HYPERPROINSULINEMIA DEVELOPS IN PARALLEL WITH PROGRESSIVE Β-CELL DYSFUNCTION. THUS, MEAN LEVELS OF PRO-INSULIN ARE SIGNIFICANTLY HIGHER DURING A GDM PREGNANCY AS COMPARED TO A NORMAL PREGNANCY. THE PURPOSE OF THIS REVIEW IS TO ANALYSE CHANGES OF SERUM LEVELS AND THE ROLE OF INSULIN AND PROINSULINE IN THE PATHOPHYSIOLOGY OF PREGNANCIES COMPLICATED WITH GESTATIONAL DIABETES. UNDERSTANDING THE PATHOPHYSIOLOGY OF GDM IS ESSENTIAL FOR A BETTER MANAGEMENT OF THIS DISEASE.

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